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Individual

BRENDA K SWAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.R.N.P.

Contact information

Practice address
4301 WILSON ST, ENT CLINIC, FORT SILL, OK 73503-4472
(580) 558-2453
(580) 558-2427
Mailing address
4301 WILSON ST, ENT CLINIC, FORT SILL, OK 73503-4472
(580) 558-2453
(580) 558-2427

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0033710
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200048660 A
OK
Enumeration date
06/01/2005
Last updated
08/16/2011
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